There is currently no effective widely used way to dispose of unused, expired, or confiscated medicines, i.e., pharmaceuticals and personal care products (PPCPs), whether by individuals disposing of personal medicines or medical facilities disposing of larger amounts of unused medicines. Medicines are oftentimes simply thrown into the trash. Children or animals may find and ingest medicines that are simply tossed into the trash and once they reach the landfill they can seep into the ground water.
One method commonly used is to add bleach to the PPCPs to dissolve them, add kitty litter to the mixture, and then place the mixture in to the garbage. Drawbacks of this method include the inability to effectively dissolve the PPCPs, emission of noxious fumes, and if the entity destroying the PPCPs is a medical facility, the need to have large quantities of these items on hand.
Another technique is to dissolve the PPCPs in water and then add some type of flour or spice to make a pungent and unsightly mixture to discourage anyone from eating it or using it for an illegal purpose of sale or consumption. Unfortunately, many PPCPs are not readily dissolved in water, and for those wanting the mixture for illegal sale or consumption, this technique does not deter the criminal.
It is also common to attempt to dispose of the PPCPs by wrapping the unused portion in duct tape to conceal its contents and make it difficult to extract the PPCPs from the tape. However, this does not deter those wanting the PPCPs for illegal purposes.
Medication take-back programs are sometimes used, but such programs require extensive planning by communities and as such are held only once or twice a year. In addition, due to the extent of planning, broadcasting dates of the event, and the need for a law enforcement officer present to take custody of the controlled substances, such programs are often cost-prohibitive. In addition, there is no requirement that pharmacists take back unused or expired medications or that they are disposed of in any particular manner, resulting in an ad hoc practice.
At hospitals and other medical facilities, disposing of medications requires extensive training of all staff working with the unused and/or discarded medications, the medications must be sorted into separate containers, a designated locked disposal area must be provided, security personnel are needed to move the medications through the facility to the disposal area, the medications must be sent to a special disposal facility for destruction, and records must be kept and reported to negate the possibility of the medications being lost or stolen for illegal use.
The most common method for disposing of unused PPCPs is to simply dispose of them down the drain or toilet and into the sewer system. However, this results in the introduction of pharmaceutical residuals into the world's aquatic environments. Most septic systems don't destroy the PPCPs. On the contrary, they may destroy the bacteria in the septic system that aid in breaking down the waste in the household waste water. In addition, because most waste water treatment plants are not designed to remove or destroy PPCPs from waste water in the sewage system, the PPCPs may be discharged into lakes, rivers, or oceans.
According to the U.S. Geological Survey, concentrations of pharmaceutically active compounds, such as hormones (including steroids and birth control pills), antidepressants, antibiotics and antimicrobials, and chemicals from personal care products have been found in various waterways nationwide. The two largest sources of pharmaceuticals entering the sewer systems are from medical facilities (including hospitals, nursing facilities, and veterinary hospitals) and residents.
What is needed is an effective method of destroying and/or disposing of unused or expired medications. Such a method will reduce the potential for environmental impacts, reduce the amount of medication available for potential abuse or accidental ingestion, and prevent inadvertent use of expired medications.
As used herein, the terms “medicine,” “medicines,” “medication,” “medications,” and “pharmaceuticals and personal care products” (PPCPs) refer to any agent, drug, or curative substance used in treating, preventing, or alleviating the symptoms of a disease, illness, condition, or injury and shall be collectively referred to herein as “medicines.” Such medicines can be in any form, including tablets, capsules, liquids, syrups, creams, lozenges, lollipops, ointments, powders, patches, suppositories, and combinations thereof.